The policy framework

March 2013

Commissioners can use links to other policies and strategies to raise awareness of the child accident prevention agenda and build the business case for investment. This section provides an overview of the organisations that have a role to play in child accident prevention in the new health and care system, and highlights the policy links that commissioners should be aware of.

The health and care system from April 2013

The diagram below provides a simple overview of the main relationships between the organisations that will have a role to play in commissioning and delivering child accident prevention services from April 2013.

Figure 1: Organisations involved in commissioning child accident prevention services, from April 2013

Organisations involved in commissioning child accident prevention services

NHS Commissioning Board

The NHS Commissioning Board (NHS CB) will have responsibility for public health commissioning for under 5s from April 2013 until 2015. It will take over the commissioning of three key programmes:

  • health visiting
  • Family Nurse Partnership programme
  • Healthy Child Programme for under 5s.

Throughout England there will be 27 NHS CB local area teams, which will act as the ‘eyes and ears’ of the national board, gathering intelligence and working closely with CCGs, local authorities. They will also link up with health and wellbeing boards – in some cases, they might have a formal role within the structure, but this will be down to individual boards to decide.

Local authorities

Local authorities will have responsibility for public health commissioning for 5-19 year olds from April 2013 and will assume responsibility for the under 5s age group from 2015.

It’s important to note that despite the split in commissioning responsibilities across age groups, local authorities will have lead responsibility for delivering on the Public Health Outcomes Framework indicator to reduce hospital admissions from unintentional and deliberate injuries for the whole 0–18 age group, with support from other partners in the new public health system. See our topic briefing on public health commissioning for under 5s for more information on the split in responsibilities between local authorities and the NHS CB, and what it means for local authority commissioners.

Public Health England

Working through 16 centres across 4 regions, Public Health England will play an important role in providing information and intelligence to child accident prevention commissioners and public health data analysts in local authorities. The network of public health observatories, including the Child and Maternal Health Observatory (ChiMAT), will become part of Public Health England in April 2013. Each centre will provide professional support to help local authorities and other partners to maximise health improvement for their local populations.

Health and wellbeing boards

Health and wellbeing boards (HWBs) will bring together the key NHS, public health and social care leaders in each local authority area to work in partnership. The directors of children’s services and public health are statutory members of the HWB. The boards will be responsible for working with a wide range of local partners to develop joint strategic needs assessments (JSNAs) and joint health and wellbeing strategies (JHWSs), and will have links to the NHS CB via the local area teams.

Clinical commissioning groups

Clinical commissioning groups (CCGs) are groups of GPs that will be responsible for commissioning health services that meet the needs of their local populations. People involved in commissioning child accident prevention work may need to work closely CCGs in a number of areas, including maternity services and emergency care. CCGs will be accountable to the NHS CB via the local area teams.

Local safeguarding children boards and children’s trusts

Some local authorities have placed their children’s trust within the remit of the HWB or have dissolved the children’s trust and set up an HWB sub-group with responsibility for children’s health and wellbeing. Others have made the local safeguarding children board (LSCB) and/or children’s trust accountable to the HWB.

Policy links

Child accident prevention links in with many policy areas. Commissioners can use these links to raise the profile of child accident prevention, embed child accident prevention into different policy and strategy areas, and build the business case for investment. This section outlines the main policy links for child accident prevention work.

Healthy Lives, Healthy People

Taking better care of children’s health and development, including preventing injuries, is an integral part of Healthy Lives, Healthy People, the new strategy for public health in England which was published in November 2010. Read more about the public health white paper in our news section.

Public Health Outcomes Framework

Published in January 2012, the Public Health Outcomes Framework, supports the public health strategy. It includes specific outcome indicators for child injuries, the key one being ‘hospital admissions caused by unintentional and deliberate injuries in under 18s’. Read more about the Public Health Outcomes Framework in our Advocating Child Safety resource.

Marmot Review

The Marmot Review report ‘Fair Society, Healthy Lives’, published in 2010, stressed the need for health inequalities to be tackled through partnership working across local and central government and the voluntary and private sector. Read more on the Marmot Review in our news section.

QIPP - Quality, Innovation, Productivity and Prevention

The QIPP programme is a national strategy involving all NHS staff, patients, clinicians and the voluntary sector. It aims to improve the quality and delivery of NHS care while reducing costs to make £20 billion efficiency savings by 2014/15. Unintentional injury prevention supports the QIPP urgent and emergency care workstream, which aims to reduce A&E attendances, as well as associated ambulance journeys and hospital admissions.

NICE guidance

In November 2010 NICE published public health guidance on preventing unintentional injuries among under 15s (PH29) and preventing unintentional injuries among under 15s in the home (PH30). The NICE website offers a self-assessment tool to help you assess your local position in relation to the guidance on injury prevention among under-15s. Read more about the NICE guidance in our news section.

Children and Young People’s Health Outcomes Forum report

The Children and Young People’s Health Outcomes Forum report focuses on addressing health inequalities among children and young people, with childhood accidents as one of the headline factors. It also highlights the importance of partnership working and the need for JSNAs to include comprehensive data for all children and young people. Read more about the Children and Young People’s Health Outcomes Forum report in our news section.

You can also read the Department of Health’s response to the recommendations made in the report.

Related links

Making the Link

External sites

Updated June 2013